Acute fatty liver of pregnancy - Revision history

Ostermayer at 23:25, 12 January 2026

2026-01-12T23:25:48Z

← Older revision		Revision as of 23:25, 12 January 2026
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	<!--T:12-->		<!--T:12-->
	At least six of the following findings, in the absence of another cause:ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>		At least six of the following findings, in the absence of another cause:<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>
	*[[Special:MyLanguage/Vomiting\|Vomiting]]		*[[Special:MyLanguage/Vomiting\|Vomiting]]
	*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]		*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]

Ostermayer at 17:15, 10 January 2026

2026-01-10T17:15:17Z

← Older revision		Revision as of 17:15, 10 January 2026
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	====Swansea criteria<~~ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>~~==== <!--T:11-->		====Swansea criteria<==== <!--T:11-->


	<!--T:12-->		<!--T:12-->
	At least six of the following findings, in the absence of another cause:		At least six of the following findings, in the absence of another cause:ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>
	*[[Special:MyLanguage/Vomiting\|Vomiting]]		*[[Special:MyLanguage/Vomiting\|Vomiting]]
	*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]		*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]
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	*Coagulopathy: elevated prothrombin time or PT		*Coagulopathy: elevated prothrombin time or PT
	*Microvesicular steatosis on liver biopsy		*Microvesicular steatosis on liver biopsy


	==Management== <!--T:13-->		==Management== <!--T:13-->

Ostermayer: Marked this version for translation

2026-01-06T16:59:04Z

Marked this version for translation

← Older revision		Revision as of 16:59, 6 January 2026
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	<translate>		<translate>

	==Background==		==Background== <!--T:1-->

			<!--T:2-->
	[[File:Sobo 1906 389.png\|thumb\|Inferior view of the liver with surface showing lobes and impressions.]]		[[File:Sobo 1906 389.png\|thumb\|Inferior view of the liver with surface showing lobes and impressions.]]
	*Rare, potentially fatal complication that presents in second half of pregnancy or (less commonly) early postpartum		*Rare, potentially fatal complication that presents in second half of pregnancy or (less commonly) early postpartum
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	==Clinical Features==		==Clinical Features== <!--T:3-->

			<!--T:4-->
	*Usually presents in 3rd trimester, but may occur any time in 2nd half of pregnancy to early postpartum		*Usually presents in 3rd trimester, but may occur any time in 2nd half of pregnancy to early postpartum
	*[[Special:MyLanguage/Nausea/vomiting\|Nausea/vomiting]] (commonly severe)		*[[Special:MyLanguage/Nausea/vomiting\|Nausea/vomiting]] (commonly severe)
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	==Differential Diagnosis==		==Differential Diagnosis== <!--T:5-->

	</translate>		</translate>
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	==Evaluation==		==Evaluation== <!--T:6-->


	===Workup===		===Workup=== <!--T:7-->

			<!--T:8-->
	*[[Special:MyLanguage/LFTs\|LFTs]]		*[[Special:MyLanguage/LFTs\|LFTs]]
	**ALT/AST usually in 300-500 range, alk phos usually elevated in pregnancy		**ALT/AST usually in 300-500 range, alk phos usually elevated in pregnancy
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	===Diagnosis===		===Diagnosis=== <!--T:9-->

			<!--T:10-->
	*Often initially misdiagnosed as [[Special:MyLanguage/preeclampsia\|preeclampsia]]/[[Special:MyLanguage/HELLP\|HELLP]]		*Often initially misdiagnosed as [[Special:MyLanguage/preeclampsia\|preeclampsia]]/[[Special:MyLanguage/HELLP\|HELLP]]
	**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP		**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP


	====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>====		====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>==== <!--T:11-->


			<!--T:12-->
	At least six of the following findings, in the absence of another cause:		At least six of the following findings, in the absence of another cause:
	*[[Special:MyLanguage/Vomiting\|Vomiting]]		*[[Special:MyLanguage/Vomiting\|Vomiting]]
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	==Management==		==Management== <!--T:13-->

			<!--T:14-->
	*Emergent Ob/Gyn consult		*Emergent Ob/Gyn consult
	**Delivery typically results in rapid hepatic recovery		**Delivery typically results in rapid hepatic recovery
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	==Disposition==		==Disposition== <!--T:15-->

			<!--T:16-->
	*Admit ICU or transfer to center with Ob		*Admit ICU or transfer to center with Ob


	==See Also==		==See Also== <!--T:17-->


	==External Links==		==External Links== <!--T:18-->


	==References==		==References== <!--T:19-->

			<!--T:20-->
	<references/>		<references/>
	[[Category:OBGYN]] [[category:GI]]		[[Category:OBGYN]] [[category:GI]]
	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T21:35:35Z

Prepared the page for translation

← Older revision		Revision as of 21:35, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Sobo 1906 389.png\|thumb\|Inferior view of the liver with surface showing lobes and impressions.]]		[[File:Sobo 1906 389.png\|thumb\|Inferior view of the liver with surface showing lobes and impressions.]]
	*Rare, potentially fatal complication that presents in second half of pregnancy or (less commonly) early postpartum		*Rare, potentially fatal complication that presents in second half of pregnancy or (less commonly) early postpartum
	*Exact etiology unclear, but thought to involve abnormal fetal fatty acid metabolism		*Exact etiology unclear, but thought to involve abnormal fetal fatty acid metabolism
	*Fat vesicles accumulate within hepatocytes, interfering with liver function		*Fat vesicles accumulate within hepatocytes, interfering with liver function


	==Clinical Features==		==Clinical Features==

	*Usually presents in 3rd trimester, but may occur any time in 2nd half of pregnancy to early postpartum		*Usually presents in 3rd trimester, but may occur any time in 2nd half of pregnancy to early postpartum
	*[[Nausea/vomiting]] (commonly severe)		*[[Special:MyLanguage/Nausea/vomiting\|Nausea/vomiting]] (commonly severe)
	*[[Jaundice]]		*[[Special:MyLanguage/Jaundice\|Jaundice]]
	*Findings consistent with [[preeclampsia]] in some women:		*Findings consistent with [[Special:MyLanguage/preeclampsia\|preeclampsia]] in some women:
	**[[Hypertension]]		**[[Special:MyLanguage/Hypertension\|Hypertension]]
	**Edema		**Edema
	**[[Proteinuria]]		**[[Special:MyLanguage/Proteinuria\|Proteinuria]]
	*[[Hypoglycemia]]		*[[Special:MyLanguage/Hypoglycemia\|Hypoglycemia]]
	*Often, signs/symptoms of [[DIC]]		*Often, signs/symptoms of [[Special:MyLanguage/DIC\|DIC]]
	*+/- [[encephalopathy]], [[ascites]]		*+/- [[Special:MyLanguage/encephalopathy\|encephalopathy]], [[Special:MyLanguage/ascites\|ascites]]


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Postpartum emergencies DDX}}		{{Postpartum emergencies DDX}}
			<translate>
			</translate>
	{{Jaundice DDX}}		{{Jaundice DDX}}
			<translate>


	==Evaluation==		==Evaluation==


	===Workup===		===Workup===
	*[[LFTs]]
			*[[Special:MyLanguage/LFTs\|LFTs]]
	**ALT/AST usually in 300-500 range, alk phos usually elevated in pregnancy		**ALT/AST usually in 300-500 range, alk phos usually elevated in pregnancy
	**[[Hyperbilirubinemia]]- more pronounced than in preeclampsia		**[[Special:MyLanguage/Hyperbilirubinemia\|Hyperbilirubinemia]]- more pronounced than in preeclampsia
	*BMP		*BMP
	**[[Hypoglycemia]]		**[[Special:MyLanguage/Hypoglycemia\|Hypoglycemia]]
	*[[DIC]] labs		*[[Special:MyLanguage/DIC\|DIC]] labs
	**Low fibrinogen, [[coagulopathy]]		**Low fibrinogen, [[Special:MyLanguage/coagulopathy\|coagulopathy]]
	**DIC present in as many as 70% of patients<ref>Ko H, Yoshida EM (2006). Acute fatty liver of pregnancy. Canadian Journal of Gastroenterology. 20 (1): 25–30</ref>		**DIC present in as many as 70% of patients<ref>Ko H, Yoshida EM (2006). Acute fatty liver of pregnancy. Canadian Journal of Gastroenterology. 20 (1): 25–30</ref>
	*CBC		*CBC
	**Often shows [[leukocytosis]]		**Often shows [[Special:MyLanguage/leukocytosis\|leukocytosis]]
	*[[UA]]		*[[Special:MyLanguage/UA\|UA]]
	**[[Proteinuria]]		**[[Special:MyLanguage/Proteinuria\|Proteinuria]]
	*[[RUQ US]]		*[[Special:MyLanguage/RUQ US\|RUQ US]]
	**Non-specific; the liver can even be normal in echotexture		**Non-specific; the liver can even be normal in echotexture
	**Useful to rule out other causes of obstructive biliary tract pathology.		**Useful to rule out other causes of obstructive biliary tract pathology.


	===Diagnosis===		===Diagnosis===
	*Often initially misdiagnosed as [[preeclampsia]]/[[HELLP]]
			*Often initially misdiagnosed as [[Special:MyLanguage/preeclampsia\|preeclampsia]]/[[Special:MyLanguage/HELLP\|HELLP]]
	**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP		**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP

	====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>====
			====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>====


	At least six of the following findings, in the absence of another cause:		At least six of the following findings, in the absence of another cause:
	*[[Vomiting]]		*[[Special:MyLanguage/Vomiting\|Vomiting]]
	*[[Abdominal pain]]		*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]
	*Polydipsia/polyuria		*Polydipsia/polyuria
	*Encephalopathy		*Encephalopathy
	*[[Elevated bilirubin]]		*[[Special:MyLanguage/Elevated bilirubin\|Elevated bilirubin]]
	*[[Hypoglycemia]]		*[[Special:MyLanguage/Hypoglycemia\|Hypoglycemia]]
	*Elevated urea		*Elevated urea
	*Leukocytosis		*Leukocytosis
	*[[Ascites]] or bright liver on ultrasound scan		*[[Special:MyLanguage/Ascites\|Ascites]] or bright liver on ultrasound scan
	*Elevated transaminases (AAT or ALT)		*Elevated transaminases (AAT or ALT)
	*Elevated ammonia		*Elevated ammonia
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	*Coagulopathy: elevated prothrombin time or PT		*Coagulopathy: elevated prothrombin time or PT
	*Microvesicular steatosis on liver biopsy		*Microvesicular steatosis on liver biopsy


	==Management==		==Management==

	*Emergent Ob/Gyn consult		*Emergent Ob/Gyn consult
	**Delivery typically results in rapid hepatic recovery		**Delivery typically results in rapid hepatic recovery
	*[[Dextrose]] for hypoglycemia		*[[Special:MyLanguage/Dextrose\|Dextrose]] for hypoglycemia
	*[[FFP]], [[cryoprecipitate]], and/or [[platelets]] for [[coagulopathy]] (see [[DIC]])		*[[Special:MyLanguage/FFP\|FFP]], [[Special:MyLanguage/cryoprecipitate\|cryoprecipitate]], and/or [[Special:MyLanguage/platelets\|platelets]] for [[Special:MyLanguage/coagulopathy\|coagulopathy]] (see [[Special:MyLanguage/DIC\|DIC]])


	==Disposition==		==Disposition==

	*Admit ICU or transfer to center with Ob		*Admit ICU or transfer to center with Ob


	==See Also==		==See Also==
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	==References==		==References==

	<references/>		<references/>
	[[Category:OBGYN]] [[category:GI]]		[[Category:OBGYN]] [[category:GI]]
			</translate>

Rossdonaldson1: /* Background */

2024-11-13T22:59:21Z

Background

← Older revision		Revision as of 22:59, 13 November 2024
Line 1:		Line 1:
	==Background==		==Background==
			[[File:Sobo 1906 389.png\|thumb\|Inferior view of the liver with surface showing lobes and impressions.]]
	*Rare, potentially fatal complication that presents in second half of pregnancy or (less commonly) early postpartum		*Rare, potentially fatal complication that presents in second half of pregnancy or (less commonly) early postpartum
	*Exact etiology unclear, but thought to involve abnormal fetal fatty acid metabolism		*Exact etiology unclear, but thought to involve abnormal fetal fatty acid metabolism
	*Fat vesicles accumulate within hepatocytes, interfering with liver function		*Fat vesicles accumulate within hepatocytes, interfering with liver function

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Swansea criteriaDey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339 - Free text at pubmed - Pubmed citation */

2021-11-25T13:35:48Z

Swansea criteriaDey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339 - Free text at pubmed - Pubmed citation

← Older revision		Revision as of 13:35, 25 November 2021
Line 42:		Line 42:
	**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP		**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP

	====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339 ~~- Free text at pubmed - Pubmed citation~~</ref>====		====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339</ref>====
	At least six of the following findings, in the absence of another cause:		At least six of the following findings, in the absence of another cause:
	*[[Vomiting]]		*[[Vomiting]]
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	*Polydipsia/polyuria		*Polydipsia/polyuria
	*Encephalopathy		*Encephalopathy
	*Elevated bilirubin		*[[Elevated bilirubin]]
	*[[Hypoglycemia]]		*[[Hypoglycemia]]
	*Elevated urea		*Elevated urea

Rossdonaldson1: /* Diagnosis */

2021-11-25T13:35:16Z

Diagnosis

← Older revision		Revision as of 13:35, 25 November 2021
Line 39:		Line 39:

	===Diagnosis===		===Diagnosis===
			*Often initially misdiagnosed as [[preeclampsia]]/[[HELLP]]
			**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP

	====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339 - Free text at pubmed - Pubmed citation</ref>====		====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339 - Free text at pubmed - Pubmed citation</ref>====
	At least six of the following findings, in the absence of another cause:		At least six of the following findings, in the absence of another cause:

Rossdonaldson1: /* Differential Diagnosis */

2021-11-25T13:34:56Z

Differential Diagnosis

← Older revision		Revision as of 13:34, 25 November 2021
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Often initially misdiagnosed as [[preeclampsia]]/[[HELLP]]
	**Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP
	{{Postpartum emergencies DDX}}		{{Postpartum emergencies DDX}}
	{{Jaundice}}		{{Jaundice DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2021-11-25T13:34:26Z

Differential Diagnosis

@@ Line 20: / Line 20: @@
 **Hypoglycemia, jaundice, ascites, hypofibrinogenemia all ''more'' common in AFLP
 {{Postpartum emergencies DDX}}
-===Indirect Hyperbilirubinemia===
+{{Jaundice}}
 ==Evaluation==

Rossdonaldson1: /* Diagnosis */

2021-11-25T12:31:23Z

Diagnosis

← Older revision		Revision as of 12:31, 25 November 2021
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	===Diagnosis===		===Diagnosis===
			====Swansea criteria<ref>Dey M, Reema K. Acute Fatty liver of pregnancy. N Am J Med Sci. 2012;4 (11): 611-2. doi:10.4103/1947-2714.103339 - Free text at pubmed - Pubmed citation</ref>====
			At least six of the following findings, in the absence of another cause:
			*[[Vomiting]]
			*[[Abdominal pain]]
			*Polydipsia/polyuria
			*Encephalopathy
			*Elevated bilirubin
			*[[Hypoglycemia]]
			*Elevated urea
			*Leukocytosis
			*[[Ascites]] or bright liver on ultrasound scan
			*Elevated transaminases (AAT or ALT)
			*Elevated ammonia
			*Renal impairment: elevated creatinine
			*Coagulopathy: elevated prothrombin time or PT
			*Microvesicular steatosis on liver biopsy

	==Management==		==Management==